Dead patients did not receive the dignified care they deserved because A&E staff were stretched to breaking point in what one nurse has described as a "living hell".

Mike Hayward, an A&E nurse at the Queen Alexandra Hospital in Portsmouth told the Royal College of Nursing Congress in Harrogate how his department was forced to leave the four patients in a treatment room on trolleys because staff were too busy trying to care for living patients.

The most shocking example of substandard care I have ever seen in my nursing career

Mike Hayward

Mr Hayward said during this particular shift, one day in January, there were 30 patients in his department waiting for a bed.

He warned the same events could have happened in other hospitals.

Mr Hayward told the conference what had happened to the dead patients, who were left on the trolleys for over two hours, was the "most shocking example of substandard care I have ever seen in my nursing career - and I'm ashamed."

Terrible time

This was third world care in the NHS, here and now

Mike Hayward

They had all died that morning after unsuccessful resuscitations - though he stressed their deaths were not connected with the pressures on the department.

But he said: "These were total strangers, left lying next to each other without the dignity and respect of last offices being performed - not because we didn't want to but because it was physically impossible."

Mr Hayward, who described the last six months as the worst period of his nursing career, said: "This was third world care in the NHS, here and now."

He said the only solution was to open more beds providing medical care with enough nurses to man them, so that pressure could be taken off casualty departments, and patients could be given the care they needed in the right place.

He added that even though there is a new plan to reform NHS emergency care, few key people had implemented it, or even read it.

He issued a warning to Health Secretary Alan Milburn, due to speak to the Congress on Wednesday, saying: "The honeymoon is over, the clock is ticking. Stop third world care in our NHS now.

"The nurses of this country are holding you to account and this time you¿ve got no excuses."

On the day Mr Hayward described to the conference, there were too many patients coming in through the front door of the department - and too few out going out of the back, into the hospital.

Similar pressures

Other A&E departments in nearby Chichester and Southampton were also under the same pressures.

There was nothing his over-stretched staff could do.

He said: "Every available corridor space was utilised, every bed and every trolley occupied."

Mr Hayward described how a heroin addict who was waiting on a chair had a respiratory arrest, where a patient stops breathing and could have suffered a coronary arrest.

He said: "He fell down from his chair and cracked his head open. We had to resuscitate him on the floor.